Provider Demographics
NPI:1013024967
Name:HANESWORTH, ERICA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:
Last Name:HANESWORTH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4017 STOCKBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-7538
Mailing Address - Country:US
Mailing Address - Phone:843-556-2898
Mailing Address - Fax:843-805-5798
Practice Address - Street 1:109 BEE ST # 119
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-5703
Practice Address - Country:US
Practice Address - Phone:843-789-6473
Practice Address - Fax:843-805-5798
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC94481835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy